Provider Demographics
NPI:1619668118
Name:RIVERA ROSADO, SONIA IVELISSE
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:IVELISSE
Last Name:RIVERA ROSADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 55 BOX 9220
Mailing Address - Street 2:
Mailing Address - City:CEIBA
Mailing Address - State:PR
Mailing Address - Zip Code:00735-9653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE ESCUDERO #250
Practice Address - Street 2:
Practice Address - City:CULEBRA
Practice Address - State:PR
Practice Address - Zip Code:00775
Practice Address - Country:US
Practice Address - Phone:787-348-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health